# FAMILY TREE DENTAL GROUP ONE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083970792
- **Authorized official:** JESSICA LEE AZUA (OFFICE MANAGER)
- **Authorized official phone:** (512) 310-5999

## Contact information

- **Practice address:** 200 N RED BUD LN, ROUND ROCK, TX 78665-8904
- **Practice address phone:** (512) 310-5999
- **Practice address fax:** (512) 341-9950
- **Mailing address:** 200 N RED BUD LN, ROUND ROCK, TX 78665-8904
- **Mailing address phone:** (512) 310-5999
- **Mailing address fax:** (512) 341-9950

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2012
- **Last updated:** 04/06/2012